A national quality improvement initiative to reduce deaths by 25% over the next 25 years: a community based approach to early detection of heart failure

#25in25

COMMITMENT

The BSH is committed to reducing the number of heart failure deaths by 25% over the next 25 years. This would mean 5 fewer deaths for every 100 patients newly diagnosed with heart failure every year, saving 10,000 lives annually.

In March 2023, BSH held a summit inviting 45 healthcare organisations to commit to a declaration to collaboratively reduce unnecessary and untimely deaths due to heart failure. This has since grown to 58 organisations and recognised as a landmark initiative by the European Society for Cardiology.

This life changing concept has been translated into a practical action plan. Called the Fast Track Communities Initiative (FTCI), BSH intend to achieve this goal through a continuous ‘Quality Improvement’ model, based on a roadmap for community engagement developed at the summit, supported by BSH and the stakeholder organisations. This will guide the development of bespoke plans tailored to local needs and demographics, with purposeful reach into areas of deprivation and lesser engaged communities.

TRANSFORMATION

PILOT SITES

Following a period of discovery and development, BSH are now in the pilot phase. Having appointed an experienced programme manager, 7 pilot sites have been selected to finesse the initiative prior to national rollout in 2025. These pilot sites are:

  • Blackpool

  • Liverpool

  • Swansea

  • Birmingham

  • Peterborough

  • Jersey

  • Glasgow

Fast track communities:

Implementation of the 25in25 will be though a ‘Fast-Track Communities’ QI programme, a sustainable and inclusive approach to improve population health by detecting undetected heart failure. This is the first time that a bottom-up, grassroots approach has been applied in primary care, using a unique quality improvement model, specifically designed to find people at risk of, or with heart failure. Progress will be tracked across 5 domains:

  • Detection

  • Risk

  • Diagnosis

  • Treatment

  • Quality of Life

QUALITY
IMPROVEMENT

The BSH has commissioned NHS Benchmarking Network to build an intelligently designed platform to extract data from General Practice records to identify individuals that need an intervention, before they become acutely unwell, thus preventing adverse incidents and health decline.

The BSH needs further support and investment in this transformational project for the national roll out and to encourage more communities to join the initiative in its infancy. Dynamically increasing the project team will enable better outreach to communities, identifying local needs, addressing diversity and inclusion as well as targeted fundraising. It will also further upskill the wider health and social care community whilst attracting new talent to specialise in heart failure. We plan to embed this in routine care and become sustainable through reducing costly admissions

DONATE

By detecting heart failure early, we will save lives, prevent heart failure reduce costly hospital admissions. Reducing acute and emergency care costs will enable resources to be allocated to FTCI, making the initiative sustainable at site level. Proof of concept with demonstrable positive outcomes at 2028, then releases BSH from ongoing financial commitment.

OUTCOMES

Cardiovascular diseases are the leading cause of death in the UK and globally, accounting for about a third of lives lost each year.

Heart failure prevalence in the UK is set to double by 2040.

Over 1 million people in the UK have heart failure, with 200,000 new diagnoses every year.

It is estimated that there are a further 400,000 people with heart failure who are currently undetected, undiagnosed, and consequently, missing out on life-preserving treatments.

These numbers are on the rise due to several factors including the anticipated exponential growth in (our ageing) population.

SCALE OF THE PROBLEM

In the UK, 80% of heart failure is diagnosed in hospital where 40% of people had symptoms that should have triggered an earlier assessment in primary care in the months prior.

Heart failure currently takes up 2% of the entire NHS budget.

The human and economic costs are huge and emphasises just how important it is to take action now.

This initiative is time critical. We must begin now to deal with the predicted doubling of heart failure patients by 2040. Within 3 years we predict 200,000 new heart failure patients, as yet undiagnosed, will have been identified and treated.

Help us lead the way, save 10,000 lives a year and embed this initiative in the fabric of our health systems.

TIME IS NOW

MATERIALS

The roadmap to detect the undetected will be the foundation of a custom platform which will be used by communities’ comprising of health and social care professionals, local politicians, public health, community groups and faith-based organisations, dependent on demographics and local needs. The platform will identify trends in population health that will inform and future proof community planning and resource allocation.

Working together with allied organisations focusing on the care of the ‘whole person’ across all ages, genders, races, ethnicities, and socioeconomic circumstances and looking through the lens of our population’s health, the 25in25 Collaborative can accelerate action towards reducing deaths due to heart failure.

In the light of the snap General Election scheduled for 4th July 2024, we are pleased to share with you the British Society for Heart Failure Manifesto which focuses on our 25in25 initiative. This document has been shared with policymakers across the health landscape. We hope that the Manifesto will go some way to support our shared ambitions. 

COLLABORATORS

The BSH are delighted to be partnered with

Each partner brings unique skills and expertise integral to discovery and development of the most effective system for national and international rollout to reduce heart failure deaths by 25% in the next 25 years.

Summit to tackle Heart Failure - March 9th 2023 was a historic day

The British Society for Heart Failure were delighted to host expert organisations from across the cardiovascular and wider health community, from the UK and internationally, to come together to change the direction of heart failure and improve the lives of millions of patients in the UK and internationally. 45+ organisation signed the declaration and committed to a long term plan, working together to save lives

Organisations with heart failure intersectionality endorsed a declaration and participated in a workshop to co create a practical roadmap to achieve the 25in25 goal through a Fast Track Community quality improvement Initiative FTCI). We committed to uniting as leaders towards a shared goal — to reduce heart failure deaths by 25% in 25 years. Beginning with agreeing on the priorities at the meeting, together, we will save lives.

As a collective, we will leverage our reach, infrastructure and human capacity to build a more equitable, inclusive, prosperous and sustainable future for all those in danger of dying from heart failure, regardless of circumstances.

Together, we can turn the tide on this life-limiting condition and benefit our communities.

“My plea is, that we make the day of the summit, the day that everything changed for those with heart failure”

  • All Wales Heart Failure Nurse Forum

  • Alliance for Heart Failure

  • Alliance for Scotland

  • Amyloidosis UK

  • Association of Nephrology Nurses

  • Association for the Study of Obesity

  • Atrial Fibrillation Association (AFA)

  • Avec

  • British and Irish Hypertension Society

  • BACPR

  • BANCC

  • British Cardiovascular Society

  • British Geriatric Society

  • British Heart Foundation

  • British Heart Rhythm Society

  • British Heart Valve Society

  • British Society of Echocardiography

  • CaReMe

  • Cardiological Society of India

  • Cardiomyopathy UK

  • Cardiorenal Forum

  • Catalan Society for Heart Failure

Stakeholders

  • Chest Heart and Stroke Scotland

  • Department of Health and Social Care

  • Diabetes Africa

  • Diabetes Specialist Nurse Forum UK

  • Diabetes UK

  • Faculty of Public Health

  • GIRFT

  • Global Heart Hub

  • Heart Failure Association of the European Society of Cardiology

  • Heart Failure Policy Network

  • Heart Failure Society of America

  • HeartLife Foundation, Canada

  • Heart UK

  • Heart Valve Voice

  • hFRenDs

  • Irish Association of Heart Failure Nurses

  • Kidney Care UK

  • NHS Benchmarking Network

  • NHS Wales

- Andy Smith, BSH Patient Advisor

  • NI Chest Heart and Stroke

  • NI Heart Failure Nurse Forum

  • NI Heart Failure Warriors

  • Obesity Health Alliance

  • Primary Care Cardiovascular Society

  • Primary Care Diabetes Society

  • Primary Care Pharmacy Association

  • PRIMIS

  • Resuscitation Council UK

  • Royal College of General Practitioners

  • Scottish Heart Failure Nurse Forum

  • Society of Endocrinologists

  • Society for Acute Medicine

  • South Asian Health Foundation

  • Spanish Society for Heart Failure

  • Strategic Intelligence Alliance for Health

  • Heart Failure Hub Scotland

  • UK Clinical Pharmacy Association

  • UK Kidney Association

  • Wales Cardiac Network

This initiative has been partially funded by grants from Astrazeneca UK and Boehringer-Ingelheim Ltd.